Timber and Straw: The Story of a Village Clinic in Malawi
Written by Michael Hanly, Desk Officer for Malawi and Zimbabwe, Concern Worldwide
In many of the countries where Concern Worldwide works, health care services can be extremely hard to come by. Malawi is no different. Mothers often have to walk for hours to get to the nearest health center—a major barrier that keeps them, and their children, from getting care when they need it.
Concern is working to make health care more accessible to communities in two areas in central Malawi, Nkhotakota and Dowa. The point of the program is to prevent and treat the major killers of children under five years old—malaria, respiratory infection, diarrhea and malnutrition—by working with the Ministry of Health to make sure there are trained health workers based in villages, not just in centralized health centers.
I recently visited a village called Kalebe in Nkhotakota. When Concern offered to support the services of a trained health worker in their village, families in the community were so thrilled that they offered to build the local clinic themselves. They provided all of the timber, straw, water, and sand used to build the clinic. Whatever materials were still needed, they saved their money to help purchase. Together, they built the clinic from the ground up.
We saw this pattern repeated village after village—if Concern could provide a trained health worker and a start-up kit of all the drugs supplies, then communities would build the clinics for them to work in. I found this determination to bring health care services closer to home to be nothing short of remarkable. They did not just want a handout. They wanted to be a part of improving their communities—and were proud of the clinics that they built.
Because these clinics were designed specifically to fight common illnesses that affect children, particularly those under five, they provide a critical first-line of defense from diseases, like malaria, that claim the lives of millions of children every year. The Kalebe village clinic alone serves 913 people—155 of whom are children. Their health worker, Halidi Bwanali, was trained by the Ministry of Health to treat common childhood illnesses, and he staffs the clinic, which opens Tuesdays and Thursdays each week. When he is not in the clinic, Halidi also takes patients in his home.
The day I visited Kalebe clinic was a busy one. Thirty-seven children were there for care. While I was there, I met a mother, Margaret Lajabu. She arrived very early with her daughter, Yankho, who had diarrhea. She explained that the clinic was a short walk from her home and that before the clinic opened, whenever they needed to see a doctor or nurse, they would have to travel to the main health center—a six-mile journey by foot.
I watched quietly as Halidi examined Yankho. He confirmed that she was still hydrated, but prescribed oral rehydration salts (ORS) and zinc so that she stayed that way. He showed Margaret how to mix the ORS in water—and explained the importance of that water being clean—and then gave the solution to Yankho to start the treatment right away.
I thought about how different Yankho’s condition might have been if Halidi was not close by and they had to walk six miles just to get care. I also thought of my own two boys, who are three and five years old, and how since their birth they have never gone without seeing a doctor when they are ill. Our doctor is just a five-minute walk from our house.
It’s hard to imagine walking two hours with your sick child just so that he or she can see a doctor, but if I did, I like to think that I would be like the mothers in Kalebe and other villages across Central Malawi, who did not wait for a clinic to come to them, but who came together, fueled by passion and determination, and built it themselves.